HIFU treatment- what’s involved?

It is becoming more popular which is good because the side effects are minimal.

Old Barry on this profile posts often and has quite a bit of experience with HIFU. Do accept that it is not unusual to require another treatment after a few years.

https://community.prostatecanceruk.org/default.aspx?g=profile&u=2428

Hi Jim, thanks for your message.  My cancer is 4-6ml and my PSA was 1.9 three years ago and has risen to 3.7 back in May. My brother has Prostate Cancer and therefore I’m told it’s best to have treatment now. I have no symptoms. Hope this helps. Cheers Des

Hi DR,

I have had HIFU on two occasions as salvage treatment for failed RT but the procedure would be very similar if you were having it as a primary treatment. It should only be administered if it is believed that the cancer is confined to the Prostate and to where the probe can focus. (Some areas cannot be reached). Furthermore, the objective is to treat only 'significant tumours'. This can help explain why post HIFU PSA may be higher than with RP and RT.

Rarely HIFU is administered under an Epidural but normally under a GA, as was for my case on both occasions. You have to have had a good MRI and pass preop tests before the treatment and a powerful quick acting laxative is given immediately before the HIFU. You then have the GA and come round two hours or thereabouts thereafter. Clearly, the number and size of tumours to be treated will affect the time in a particular case. Very soon after coming round I was eating a sandwich and drinking a cuppa. Bruising was more apparent the day after for a couple of days but I found the catheter very uncomfortable but the situation was 90% better when this was taken out with ease a week later. Passing of urine was back to pre treatment level when the catheter was removed and there was a miniscule amount of blood on the first occasion only. However, my tumour was small and logically one might expect rather more blood and possibly clots with larger/more tumours. I found standing or lying down easier and immediately after my second HIFU I was driven home some 200 miles from UCLH in London. I found it easier to slouch when sitting, as sitting upright put unwanted pressure on the catheter area until this was removed .

I can't comment with regard to ED, as the RT I had years previously brought this about but am aware that HIFU compares favourabl. in this respect.

For men that are suitable for HIFU, it is an easy procedure with mild side effects. It may need repeating (as in my case) but my PSA at 6 months after treatment is 0.02 which is excellent for a man still having a Prostate albeit a radiated one. Where HIFU does not work as hoped for, it can be followed by surgery or a form of RT.

My advice for any man for whom HIFU is considered an option, would be to get a opinion from UCLH who also do Ireversible Electro Poration, often referred to as Nanoknife which may be more suited to some men than HIFU.

This is a little dated now but gives some useful info about HIFU and briefly mentions other types of focal therapy. If you watch it all you can see what goes on while you are under GA. https://www.youtube.com/watch?v=CHchSGAesg8

Edited by member 12 Aug 2022 at 04:15  | Reason: to highlight link

I had partial HIFU (60% of my prostate) in Aug 2017. Very few side effects except dry orgasms and weaker urine flow. However, the PCa has now spread to 6 of my pelvic lymph nodes and I have been on Bicalutamide 50mg pills for 2 weeks and had my first ADT injection (Decapeptyl 3mg 1 month) yesterday. Very few side effects from the pills but too early to tell re. the injection.

My lay advice is that if you're going to have HIFU (and imho it is true that it is has fewer side effects - particualrly sexual and is of course non-invasive) is that you have it to the WHOLE prostate not just partial as I did. 

I was also Gl 7 (3+4) buy it looks like the surgeon left some minor GL 6 in one side of my prostate - and that has now had consequences. Hope this is of some help. Best with your treatment. 

Des  I was talking about the self injections for ED, caverject or Invicorp25 etc.

Hi Barry, just to let you know I had HIFU treatment on 29 September. I had a catheter in for a week and it was taken out on Friday. I feel very lucky as I have no side effects at all. No erectile dysfunction or incontinence. Everything is as it was before. It’s incredible. I need a PSA test in December and an MRI scan next year September and from then on keeping a regular check on PSAs and MRI scans. Thanks for the information you put on this site, it helped me in making my decision. Thanks again Barry. 
Cheers Des